The impact of healthcare-associated infections on mortality in ICU: A prospective study in Asia, Africa, Eastern Europe, Latin America, and the Middle East
Document Type
Article
Publication Date
6-1-2023
Abstract
Background: The International Nosocomial Infection Control Consortium has found a high ICU mortality rate. Our aim was to identify all-cause mortality risk factors in ICU-patients. Methods: Multinational, multicenter, prospective cohort study at 786 ICUs of 312 hospitals in 147 cities in 37 Latin American, Asian, African, Middle Eastern, and European countries. Results: Between 07/01/1998 and 02/12/2022, 300,827 patients, followed during 2,167,397 patient-days, acquired 21,371 HAIs. Following mortality risk factors were identified in multiple logistic regression: Central line-associated bloodstream infection (aOR:1.84; P<.0001); ventilator-associated pneumonia (aOR:1.48; P<.0001); catheter-associated urinary tract infection (aOR:1.18;P<.0001); medical hospitalization (aOR:1.81; P<.0001); length of stay (LOS), risk rises 1% per day (aOR:1.01; P<.0001); female gender (aOR:1.09; P<.0001); age (aOR:1.012; P<.0001); central line-days, risk rises 2% per day (aOR:1.02; P<.0001); and mechanical venti-lator (MV)-utilization ratio (aOR:10.46; P<.0001). Coronary ICU showed the lowest risk for mortality (aOR: 0.34;P<.0001). Conclusion: Some identified risk factors are unlikely to change, such as country income-level, facility owner-ship, hospitalization type, gender, and age. Some can be modified; Central line-associated bloodstream infec-tion, ventilator-associated pneumonia, catheter-associated urinary tract infection, LOS, and MV-utilization. So, to lower the risk of death in ICUs, we recommend focusing on strategies to shorten the LOS, reduce MV -utilization, and use evidence-based recommendations to prevent HAIs. (c) 2022 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
Keywords
Risk factor, Risk factor Hospital infections, Hospital Nosocomial infections, Nosocomial infections Intensive care unit, Intensive care Worldwide, Multiple Logistic Regression
Divisions
ummc
Funders
INICC Advi-sory Board
Publication Title
American Journal of Infection Control
Volume
51
Issue
6
Publisher
Mosby-Elsevier
Publisher Location
360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA